Wound

Injury:

An injury is any harm, whatever is illegally caused to any person in body, mind, reputation, or property.

Wound

Medically a wound or injury is a break of the natural continuity of any of the tissues of the living body.

Mechanical injuries

Mechanical injuries (wounds) are injuries produced by physical violence

Trauma

Trauma is an injury inflicted by force on living tissue.

Assault

Assault is an offer or threat or attempts to apply force to the body of another in a hostile manner.

Battery

The actual application of force to the body of another.

 

Classification of injuries:

Medical:

(I) Mechanical or physical Injuries:

 

A. Due to blunt force B. Due to sharp force C. Firearms

1) Abrasions

2) Contusions

3) Lacerations

4) Fractures and dislocations

1) Incised wounds

2) Chop wounds

3) Stab wounds

1) Firearm wounds

2) Blast injuries

(II) Thermal Injuries:

1. Due to cold 2. Due to heat

a) Frostbite

b) Trench foot

c) Immersion foot

a) Burns

b) Scalds

(III) Chemical Injuries: 

  • Corrosive acids 
  • Corrosive alkalis

(IV) Miscellaneous:  
Electricity, lightning, X-rays, radioactive substances, etc.

(V) Explosions

 

Hurts

Hurts mean bodily pain, diseases or infirmity caused to any person. It does not include mental pain.

Infirmity is any inability of an organ to perform its usual function.

Legal classification

  1. Simple
  2. Grievous 

Medicolegal classification

  1. Suicide
  2. Homicide
  3. Accident
  4. Fabricated
  5. Self-inflicted
  6. Defense
  7. Ante mortem or post mortem

 

HOMICIDE:

Homicide is the killing of a human being by another human being.

Types of Homicide:

Lawful

1. Justifiable

2. Excusable

Unlawful

1. Murder

2. Culpable homicide

    a) amounting to murder  

    b) not amounting to murder 

3. Rash or negligent homicide

 
 

SIMPLE INJURY:

Simple injury is one that is neither extensive nor serious and which heals rapidly.

Eg. Bruise, laceration, abrasion

 

GRIEVOUS HURT :

It is one that is extensive/serious which doesn’t heal rapidly and which leaves a permanent deformity/disfiguration and which endanger the life or which causes the sufferer severe bodily pain.

 

Any of the following injuries are grievous.

1. Emasculation (means depriving a male of masculine vigour)

2. Permanent privation of the sight of either eye.

3. Permanent privation of the hearing of either ear.

4. Privation of any member or joint.

5. Destruction or permanent impairing of the power of any member or joint.

6. Permanent disfiguration of the head or face.

7. Fracture or dislocation of a bone or tooth.

8. Any hurt which endangers life, or which causes the victim to be in severe bodily pain, or unable to follow his ordinary pursuits for a period of twenty days.

 

Abrasions:

An abrasion (gravel rash) is a destruction of the skin, which usually involves the superficial layers of the epidermis only.

The thickness of the skin is 1.6 mm.

Mechanism of Abrasions:

They are caused by friction against a rough surface or by compressions, such as a lateral rubbing action by a blow, a fall on a rough surface, by being dragged in a vehicular accident, fingernails, thorns, or teeth bite.

Features of Abrasion:

They are simple injuries, bleeding slightly, healing rapidly and the scar is not formed.

 

Types of Abrasions

1. Scratches:

A scratch (linear abrasion) is an abrasion with length but no significant width, or a very superficial incision, depending on the agent. 

2. Grazes (sliding, scraping, or grinding abrasion):

They occur when there is movement between the skin and some rough surface in contact with it.

An abrasion caused by violent lateral (tangential) rubbing against a surface as in dragging over the ground is called brush burn or gravel rash.

Friction burn" (scuff or brush abrasion) is an extensive, superficial, reddened excoriated area without serous ooze or bleeding and with little or no linear mark. It may occur due to tangential contact with a smooth surface or when the skin is covered by clothing.

3. Pressure Abrasions (crushing or friction abrasions):

The ligature mark in cases of hanging and strangulation and the teeth bite marks are examples.

4. Impact Abrasions (contact or imprint abrasions):

e.g., when a motor tire passes over the skin, an imprint of bicycle chain, the spiral of electric wires, ropes, serrated knife, etc.

 

Age of the Abrasions:

Abrasions heal from the periphery by the new growth of epithelial cells.

Fresh: Bright red
12 to 24 hours: Lymph and blood dries up leaving a bright red scab
2 to 3 days: Reddish-brown scab
4 to 7 days: Dark brown to brownish-black scab. Epithelium grows and covers defects under the scab.
After 7 days: Scab dries, shrinks, and falls off, leaving depigmented area underneath, which gets gradually pigmented
 

 

Medicolegal Importance of Abrasion:

1. They give an idea about the site of impact and the direction of the force.

2. They may be the only external signs of a serious internal injury.

3. Patterned abrasions are helpful in connecting the wound with the object which produced them.

4. The age of the injury can be determined, which helps to corroborate with the alleged time of the assault.

5. In open wounds, dirt, dust, grease, or sand are usually present, which may connect the injuries to the scene of the crime.

6. Character and manner of injury may be known from its distribution.

  (a) In throttling, crescentic abrasions due to fingernails are found on the neck.

  (b) In smothering, abrasions may be seen around the mouth and nose.

  (c) In sexual assaults, abrasions may be found on the breasts, genitals, inner side of the thighs, and around the anus.

  (d) Abrasions on the face of the assailant indicate a struggle.

 

Differential Diagnosis of Abrasion:
(Condition/wound that looks alike abrasion)

1) Erosions of the Skin Produced by Ants

2) Excoriations of the Skin by Excreta

3) Pressure sores.

4) Drying of the skin of the scrotum produces hardened, reddish-brown coloration resembling abrasion.

 

CONTUSIONS (BRUISES)

A contusion may contain 20 to 30 ml. of blood or even more.

A contusion is an effusion of blood into the tissues, due to the rupture of blood vessels (veins, venules, and arterioles), caused by blunt trauma, such as fist, stone, stick, bar, whip, hammer, axe, wooden handle, poker, shod foot,.boot, etc.


Features of Contusions:

Painful swelling, and crushing or tearing of the subcutaneous tissues usually without destruction of the skin.
Margins are blurred, diffused
A fresh bruise is usually tender and slightly raised above the surface of the skin,
A bruise has lighter color in the center because extravasated blood is pushed outward by the impact.
Most bruises are in the subcutaneous tissues above the deep fascia.
Change color with the course of time

 

Causes of Bruise:

  • Trauma (Usually Blunt Force)
  • Non-Traumatic


Non-traumatic causes of bruises are

  1. Idiopathic thrombocytopenia purpura
  2. Leukemia
  3. Hemophilia
  4. Vitamin K & prothrombin deficiency
  5. Liver diseases
  6. Scurvy

 

Factors modifying size and shape:

1. Condition and Type of Tissue:

If the part is vascular and loose, may cause a large bruise, as there is sufficient space for blood to accumulate.

2. Age:

Children bruise more easily because of softer tissues and loose, delicate skin, and old persons bruise easily because of loss of subcutaneous tissues.

3. Sex:

Women bruise more easily than men because the tissues are more delicate and subcutaneous fat is more. Fat people bruise easily, because of the greater volume of subcutaneous tissue.

4. Natural Disease:

Purpura hemorrhagic, leukemia, hemophilia, scurvy, vitamin K and prothrombin deficiency, and in phosphorus poisoning.

5. Gravity Shifting of the Blood:

Bruises do not always appear at the site of impact. Blood will track along the fascial planes (or between muscle layers) which form the least resistance and may appear where the tissue layers become superficial (ectopic bruising, or percolated or migratory contusion)

 

Hemorrhages in the soft tissues around the eyes and in the eyelids (spectacle hematoma; black eye), may be caused by

1. direct trauma, such as a punch in the eye,

2. Blunt impact to the forehead, the blood gravitating downwards over the supraorbital bridge

 

The Age of Bruise:

The red cells disintegrate by hemolysis, and the hemoglobin is broken down into haemosiderin, haematoidin, and bilirubin by the action of enzymes.

At first: Red (due to hemoglobin)
Few hours to 3 days: Blue (due to deoxygenated hemoglobin)
4th day: Bluish-black to brown (haemosiderin).
5 to 6 days: Greenish (haematoidin).
7 to 12 days: Yellow (bilirubin).
2 weeks: Normal

 

Antemortem and Postmortem Bruising:

In antemortem bruising, there is swelling, damage to epithelium, extravasation, coagulation, and infiltration of the tissues with blood and color changes. Sign of inflammation present. These signs are absent in postmortem bruises.

Medicolegal Importance of Bruise

1. Patterned bruises may connect the victim and the object or weapon, e.g., whip, chain, cane, ligature, vehicle, etc.

2. The age of the injury can be determined by color changes.

3. The degree of violence may be determined by their size.

4. In open wounds, dirt, dust, grease, or particles of stone or sand are usually present, which may connect the injuries to the scene of a crime.

5. Character and manner of injury may be known from its distribution.

(a) When the arms are grasped, there maybe 3 or 4 bruises on one side

(b) In manual strangulation, the position and number of bruises and nail marks may give an indication of the method of attack or the position of the assailant.

(c) Bruising of the thigh, especially the inner aspect, and of genitalia indicates rape.

 

Bruises are of less value than abrasions because:

(1) Their size may not correspond to the size of the weapon.

(2) They may become visible several hours or even one to two days after the injury.

(3) They may appear away from the actual site of injury.

(4) They do not indicate the direction in which the force was applied.

 

Complications of Bruise:

(1) Multiple contusions can cause death from shock and internal hemorrhage.

(2) Gangrene and death of tissue can result.

 

Artificial Bruises :

Some irritant substances, when applied to the skin produce injuries, which simulate bruises. They are produced to make a false charge of assault.

 

Railway line/Tramline Bruise

A blow with a rod, a stick, or a whip produces two parallel, linear hemorrhages (railway line or tram line type).

 

Laceration: (Rupture or Tear)

Lacerations are tears or splits of skin, mucous membranes, muscle, or internal organs produced by the application of blunt force to the broad area of the body, which crushed or stretched tissues beyond the limits of their elasticity.


Mechanism of Laceration:

Localized portions of tissue are displaced by the impact of the blunt force, which sets up traction forces and causes tearing of the tissues.

Blunt impact to any bony area of the body is likely to produce contusion when overlying tissues are forcibly and rapidly compressed against the bone, e.g. scalp, shins, shoulders, and face.

The edges are irregular and rough, because of the crushing and tearing nature of the blunt trauma.

The margins are contused due to the bleeding into the tissues caused by trauma.


Types of Laceration:

1. Split Lacerations:  Splitting occurs by crushing of the skin between two hard objects.

2. Stretch Lacerations: Over-stretching of the skin, if it is fixed, will cause a laceration.

3. Avulsion (shearing laceration) :

4. Tears:

5. Cut Lacerations:

 

Incised-like or Incised-looking Wounds: (A type of split laceration)

Lacerations produced without excessive skin crushing may have relatively sharp margins.

Blunt force on areas where the skin is close to the bone, and the subcutaneous tissues are scanty, may produce a wound which by a linear splitting of the tissues (as the skin is easily stretched during impact), may look like an incised wound.

Sites are the scalp, eyebrows, cheekbones, lower jaw, iliac crest, perineum, and shin.

Incised wound and incised looking wound can be differentiated by using magnifying glass:

Incised wound Incised-looking wound
Margin- clean-cut, Regular Margin- Ragged, irregular edge
 

 

Difference between incised & incised looking wound

  Incised wound Incised looking wound
Type Truly incised wound Truly split laceration
Weapon Sharp cutting wound Blunt weapon
Site Anywhere Mainly over the bony prominence
Edges Clean cut & regular Ragged & irregular edge
Bleeding Profuse bleeding Slightly
Hair bulbs Cleanly cut Crushed or torn
Bruising, Abrasion Usually absent May be present

 

 

 

Characters of Laceration:

1) Margins are irregular, ragged, and uneven

2) Bruising is seen either in the skin or the subcutaneous tissues around the wound.

3) Deeper tissues are unevenly divided with tags of tissues - Tissue bridges (bridging fibres)

4) Hair bulbs are crushed.

5) Hair and epidermal tags may be driven deeply into the wound.

6) Hemorrhage is less because the arteries are crushed and torn across irregularly, and thus retract and the blood clots readily,

9) The shape and size may not correspond with the weapon or object which produced it.

 

Combinations of Abrasions, Contusions, and Lacerations:

Abrasions, contusions, and lacerations are frequently seen together or as integral parts of one another.

Antemortem lacerations show bruising, abrasion, gaping, and blood-staining of margins, greater bleeding, and vital reaction.

 

Complication of Laceration

  • Shock
  • Hemorrhage
  • Injury to vital organs
  • Crush syndrome  
  • Infection
  • Pulmonary or systemic fat embolism may occur due to the crushing of subcutaneous tissue.

 

Medicolegal Importance of Laceration :

1. The type of laceration may indicate the cause of the injury and the shape of the blunt weapon.

2. Foreign bodies found in the wound may indicate the circumstances in which the crime has been committed.

3. The age of the injury can be determined.

 

Incised wound: (Cut/Slice)

An incised wound (cut, slice) is a clean-cut through the tissues, (usually the skin and subcutaneous tissues, including blood vessels), caused by a sharp-edged instrument. The wound is longer than it is deep.

Mechanism of incised wound:

It is produced by the pressure and friction against the tissue, by an object having a sharp-cutting edge, such as knife, razor, scalpel, scissors, sickle, cleaver, sword, etc.

Characters of Incised wound:

1. Margin:

The edges are clean-cut, well-defined, and usually everted.

The edges may be inverted if a thin layer of muscle fibers is adherent to the skin as in the scrotum. The edges are free from contusions and abrasions.

2. The depth of the wound will not show any bridging tissue.
3. Width is greater than the thickness of the edge of the weapon causing it.
4. Length is greater than its width and depth,
5. Usually spindle-shaped
6. Hemorrhage: 
As the vessels are cut cleanly, the hemorrhage is more. If the artery is completely cut, the bleeding will be more due to its inability to contract or retract.

7. Incised wounds are deeper at the beginning and become increasingly shallow towards the end of the cut the wound is called Tailing of the wound. This indicates the direction.

 

Sites where the edges of incised wounds are inverted

  1. Neck
  2. Axilla
  3. Scrotum

Because of loosely attach of a thin layer of muscles fibers with skin.

 

Age of Incised Wound :

Fresh: Haematoma formation.

12 hours: The edges are red, swollen, and adherent with blood and lymph; leucocytic infiltration.

24 hours: A continuous layer of endothelial cells cover the surface; overlying this a crust or scab of dried clot is seen.

4 to 5 days: New fibrils are formed. Epithelial cell proliferation continues, forming a thickened layer.

One week: Soft, reddish scar formation in small wounds.

 

Causes of death in incised wound

Excessive bleeding- hemorrhage- shock
In cut-throat injury- cocking of respiratory passage by blood- Asphyxia

 

Medicolegal Importance of incised wound:

(1) They indicate the nature of the weapon (sharp-edged).

(2) The age of the injury can be determined.

(3) They give an idea about the direction of the force.

(4) Position and character of wounds may indicate mode of production, i.e., suicide, accident, homicide.

 

Hesitation marks or tentative cuts or trial wounds:

They are cuts which are multiple, small and superficial often involving only the skin, and are seen at the beginning of the incised wound.

 

Cut-Throat wound:

It is an incised wound in front of the neck


Types of Cut-Throat wound:

  • Homicidal
  • Suicidal

 

Causes of death in cut-throat wounds

  • Hemorrhage 
  • Shock
  • Air embolism (due to involvement of internal jugular vein)
  • Septic pneumonia (due to aspiration of effused blood)

 

Postmortem Features of the suicidal cut-throat wound

Site - Left side of neck & passing across the front of the throat
Level - High, above the thyroid cartilage
Direction - from left to right & above downward in a right-handed person
No. Of wound - Multiple, maybe 20-30, 1 or 2 are severe, others are superficial hesitation cuts
Hesitation cuts - Present
Edges - usually ragged due to overlapping of multiple superficial incisions.
Tailing - Present at the right end of the wound in a right-handed person.
Defense wounds - Absent 

 

 

 

CHOP WOUNDS (Slash wounds) :

They are deep gaping wounds caused by a blow with the sharp cutting edge of a fairly heavy weapon, like a hatchet, an axe, sword, broad heavy knife, chopper, saber, or meat cleaver.

 

The character of chop wound

  • The dimensions of the wound correspond to the cross-section of the penetrating portion of the blade.
  • The margins are sharp and may show slight abrasion and bruising
  • Marked destruction of underlying organs.

 

Difference between chop wound & incised wound

Chop wound Incised wound
Caused by heavy sharp cutting weapon Caused by light sharp cutting weapon
Abrasion & bruise may present due to chopping, striking manner      Abrasion & bruise usually absent because of just drawing, sawing of weapons       
Depth - Deep Depth- Superficial
Nature of force applied- Striking Nature - Drawing, sawing
 

 

Stab or punctured wounds

A stab wound is produced when force is delivered along the long axis of a narrow or pointed object, such as a knife, dagger, sword, chisel, scissors, nail, needle. spear, arrow, screwdriver, etc. into the depths of the body.

The most common stabbing instruments are kitchen knives, sheath knives, or penknives.

 

Types of stab wounds:

1. Penetrating wound:

Weapon enters into the body cavity producing only one wound, i.e. wound of entry.

2. Perforating wound (through and through punctured around):

Weapon after entering into one side of the body will come out through the other side, producing two wounds - Wound of entry and wound of exit

 

Characters of stab wound:

1. Margin: The edges of the wound are clean-cut and inverted.

2. The wound is deeper than its length and width on the surface of the skin.

3. The shape of the wound usually corresponds to the weapon used,

 

Complications :

(1) External hemorrhage is slight but there may be marked internal hemorrhage or injuries to internal organs.

(2) The wound may get infected due to the foreign material carried into the wound.

(3) Air embolism may occur in a stab wound on the neck which penetrates jugular veins. Air is sucked into the vessels due to the negative pressure.

(4) Pneumothorax.

(5) Asphyxia due to inhalation of blood.

 

Concealed Puncture Wounds :

These are puncture wounds caused on concealed parts of the body, such as nostrils, Fontanella, fornix of the upper eyelids, axilla, vagina, rectum, and nape of the neck.

 

Incised-stab wound:

Incised-stab wound is a wound, which starts as an incised wound and ends as a stab wound by the sudden thrust of the blade into the body, or starts as a stab wound and becomes incised wound as the knife is pulled out of the body at a shallow angle to the skin surface producing an incised wound

 

DEFENSE WOUNDS :

Defense wounds result due to the immediate and instinctive reaction of the victim to save himself.

 

SELF-INFLICTED AND FABRICATED WOUNDS:

Self-inflicted wounds are those inflicted by a person on his own body.

Fabricated wounds are those which may be produced by a person on his own body (self-inflicted), or by another with his consent.

 

Motive of Fabricated wound:

1. To charge an enemy with assault or attempted murder.

2. To make a simple injury appear serious.

3. By the assailant to pretend self-defense or to change the appearance of wounds, which might connect him with the crime.

4. By policemen and watchmen acting in collusion with robbers to show that they were defending the property.

5. In thefts by servants or messengers for the above reason.

6. By prisoners, to bring a charge of beating against officers.

7. By recruits to escape military service.

8. By women to bring a charge of rape against an enemy.

 

Therapeutic Wounds:

These are wounds produced by doctors during the treatment of a patient, such as surgical stab wounds of the chest for insertion of chest tubes, of the abdomen for drains, thoracotomy and laparotomy incisions, incisions on the wrists, antecubital fossae and ankles, and tracheostomy incisions.

 

WOUND CERTIFICATE:

Preliminary particulars: The following particulars should be noted.

(1) Serial number.

(2) Name, age, and sex of the injured person and address. (3) Father's or guardian's name.

(4) Date, time, and place of examination.

(5) Name and number of the accompanying police constable and the police station to which he belongs.

(6) Names of the persons who had accompanied the injured person with their address.

(7) A brief statement of the injured person about the exact nature of the incident, where the incident took place, time and date of the incident, details of physical force used in the assault. This is to be recorded as "alleged by the patient".

(8) Two identification marks.

(9) The size of the victim, i.e., stature, body weight, and development.

(10) The consent of the person for the examination should be taken. If the condition of the patient is serious, a dying declaration should be recorded.

 

The following are the various entries in the wound certificate.

Nature of each injury:

Size, shape, and direction of each injury:

On what part of the body inflicted

Simple, grievous, or dangerous injury:

By what weapon inflicted

Whether the weapon was dangerous or not?

Remarks

 

Causes of death from the wounds

Direct/IMMEDIATE CAUSES:

  1. Hemorrhage
  2. Reflex Vagal Inhibition
  3. SHOCK
  4. Mechanical Injury to a Vital Organ

 

Delayed/REMOTE CAUSES:

  1. Infection
  2. Gangrene or Necrosis
  3. Crush Syndrome
  4. Neglect of Injured Person
  5. Surgical Operation
  6. Natural Disease
  7. Supervention of Disease from a Traumatic Lesion
  8. Thrombosis and Embolism
  9. Fat Embolism
  10. AIR EMBOLISM
  11. ADULT RESPIRATORY DISTRESS SYNDROME (ARDS)
  12. DISSEMINATED INTRAVASCULAR COAGULATION (DIC)
  13. SUPRARENAL HEMORRHAGE
 

About 100 ml. of air introduced under pressure is necessary to produce fatal pulmonary air embolism

 

Difference between antemortem and postmortem abrasions

Trait Antemortem abrasion Postmortem abrasion
Site Anywhere on the body. Usually over bony prominences
Color Bright reddish-brown Yellowish, translucent, and parchment-like
Exudation More; scab slightly raised Less; scab often lies slightly below the level of the skin.
Microscope  Intravital reaction and congestion seen        No intravital reaction and no congestion
 

 

Difference between antemortem & postmortem bruise

  Antemortem bruise Postmortem bruise
Surface Elevated Smooth, no elevation
Sign of inflammation Present Absent
Color change Present No color change
Damage to epithelium Present Not present
Hemorrhage Considerable  Insignificant

 

Difference between post mortem staining and Bruise

  Post mortem staining Bruise
Situation On the dependent part of the dead body Anywhere
Tissue level Under the skin Subcutaneous level
Causes Due to capillo-venous distention with blood Due to extravasation of blood  from capillaries
Effect of pressure Pressed spot appears pale No change
Cut section Cut surface shows oozing of blood from smaller vessels which can be cleaned by washing Cut surface shows evidence of hemorrhage in the tissue which cannot be washed out by a gentle stream of water
Appearance No elevation of the involved area Often swollen because of extravasated blood and edema.
Color Uniform bluish-purple in color Change color with the course of time
Epidermis Not abraded Maybe abraded
Medico-legal importance Tells about the time of death and position of the dead body Tells about the nature of injury, weapon, used, etc.
 

 

Difference between post mortem staining & congestion

 

  Post mortem staining Congestion
Situation Dependent part of the organ Whole part of organ, affected with pathology
Cut surface Oozing of blood from distended capillaries Exudation of fluid mixed with blood from the cut surface
Cause Passive capillo-venous distention Due to some pathology in organ
Nature Post-mortem Ante-mortem
Swelling Nil May present
 

 

Difference between Bruise and congestion

  Bruise Congestion
Cause Mechanical force Pathological conditions eg. Inflammation, capillary stasis
Level of tissue involved Subcutaneous or submucosa level with rupture of capillaries Intravascular phenomenon with engorgement of capillaries
Margin Diffused Well defined
Color Change from red to blue, brown, green & yellow All along dusky red without any change
Cut surface Show extravasation which is not washable Bleeding occurs from engorged vessels which is washable.
 

 

Difference between a true bruise and artificial bruise

  Artificial bruise True bruise
Cause Juice of marking nut, calotropis, or plumbago rosea Trauma
Site Exposed accessible parts. Anywhere.
Color Dark-brown Typical color changes
Shape
Irregular Rounded
Margin Well-defined Diffuse, irregular
Itching Present Absent
Contents Acid serum Extravasated blood
Chemical test Positive for the chemical Negative
 

 

Difference between incised, lacerated, and stab wounds

  Incised wound Lacerated wound Stab wound
Manner of production By sharp objects or weapons By blunt objects or weapons By pointed sharp or blunt weapons
Site Anywhere Usually over the bony prominence Anywhere; usually chest and abdomen
Margins Smooth, even, clean-cut, and everted Irregular and often undermined Clean-cut, parallel edges.
Abrasion on edges Absent Usually present Absent
Bruising No adjacent bruising of soft tissues. Bruising of surrounding and underlying tissues Rare
Shape Linear or spindle-shaped Varies; usually irregular Linear or irregular
Dimensions Usually longer than deep; often gaping Usually longer than depth Depth greater than length and breadth
Depth of wound Structures cleanly cut Tissue bridge/bridging fibers present Structures cleanly cut
Hemorrhage Usually profuse and external Slight except scalp Varies; usually internal.
Hair bulbs Cleanly cut. Crushed or torn Cleanly cut.
Bones May be cut Maybe fractured Maybe punctured
Clothes May be cut May be torn May be cut

 

Difference between incised & incised looking wound

  Incised wound Incised looking wound
Type Truly incised wound Truly split laceration
Weapon Sharp cutting wound Blunt weapon
Site Anywhere Mainly over the bony prominence
Edges Clean cut & regular Ragged & irregular edge
Bleeding Profuse bleeding Slightly
Hair bulbs Cleanly cut Crushed or torn
Bruising, Abrasion Usually absent May be present
 

 

 

Difference between suicidal and homicidal cut-throat wounds

  Suicidal cut-throat wound Homicidal cut-throat wound
Situation Left side of the neck and passing across the front of the throat Usually on both sides
Level High; above the thyroid cartilage Low; on or below the thyroid cartilage
Direction  Usually Above downwards and from left to right in a right-handed person Transverse or from below upwards
Tailing Usually present at the end of the wound Absent
Number of wounds Multiple, maybe 20 to 30, superficial, parallel, and merged with the main wound; rarely single. Multiple, cross each other at a deep level; not repeated in depths of the main wound
Edges Usually ragged (irregular, uneven outline) due to overlapping of multiple superficial incisions Sharp and clean-cut
Hesitation cuts Present Absent
Defence wounds Absent Present
Hands Weapon may be firmly grasped due to cadaveric spasm Fragments of clothing, hair, etc., may be grasped.
Vessels Carotid artery does not injure, usually Jugular vein and carotid artery are likely to be cut
Scene of crime Undisturbed Disturbed
Depth Not so deep Very deep
Severity Less Very severe
 

 

Differences between suicidal, homicidal, and accidental wounds

 

  Suicide wound Homicide wound Accident wound
Nature of wounds Usually incised and stab. Usually chop wounds, lacerations, and stab Usually lacerations, abrasions, and contusions
No. of wounds Multiple; rarely single Multiple Usually single, maybe multiple
Target area Accessible parts only Anywhere Anywhere
Direction In right-handed persons from left to right and from above downwards Any direction Any direction
Severity Mostly superficial; one or two deep wounds Mostly severe and extensive Variable severity
Hesitation marks Usually present Absent Absent
Defence wounds Absent May be present Absent
Weapon By the side of the body or maybe grasped firmly due to cadaveric spasm Absent Present
Clothes Not damaged as they are usually removed. May be damaged May be damaged with dirt, mud
Scene of crime No disturbances Disturbed with signs of struggle Varies with the nature of the accident
Motive Present, such as domestic worries, disappointment in love, chronic disease, failure in examination, etc. Revenge, robbery, sexual offences. Absent
 

 

 

Hemorrhage:
Hemorrhage means escape of blood from the cardiovascular system.

Types:

Hemorrhage is classified as capillary, venous, arterial, or cardiac, depending upon its origin.
Hemorrhage may be external or internal.

When bleeding occurs due to various types of wounds, it is called traumatic hemorrhage.

Bleeding that occurs in the absence of trauma is called spontaneous hemorrhage.

When a large blood vessel is injured, a tumor-like mass called hematoma is formed.

Petechiae are minute hemorrhagic spots, usually of capillary or venular origin.
Petechial hemorrhages/Tardieu Spot are rounded, pin-headed size hemorrhagic spots develop due to raised venous pressure from impaired venous return resulting in over-distention and rupture of venules. A minimum of 15 to 30 seconds is required to produce congestion and petechiae.
Petechiae vary in size from 0.1 to 2 mm. If larger than this they are called ecchymoses.

Site for looking Petechial hemorrhage:

Skin, conjunctiva, sclera, face, mucosal surfaces in the mouth, the sub-pleural surface of lung, heart

Shock is a circulatory disturbance characterized by hypo-perfusion of cells and tissues due to reduction in the volume of blood or cardiac output, or redistribution of blood resulting in a decrease of effective circulating volume.

Shock/Death usually occurs after the loss of 1/3rd of the total blood of the body.

Types of shock

  • Cardiogenic
  • Hypovolemic
  • Septic
  • Neurogenic

#Congestion means engorgement of capillaries of viscera due to stasis of blood in various pathological conditions eg. Inflammation, hypoxia, etc

 

VIEW OTHER FORENSIC NOTE

1. Identification

2. Asphyxia

3. Autopsy

4. Medical Law And Ethics

5. Legal Procedure